哪些心脏病人能怀孕?

2017-10-17 上海交通大学附属仁济医院 周琼 健康报网

结婚生子是每个女性生命中很美好的一部分,但对于有心脏病的女性来说,怀孕是她们向往却又很担心的一件事。作为一名产科医生,我们常常会被问:“医生,我有心脏病,能怀孕吗?”

结婚生子是每个女性生命中很美好的一部分,但对于有心脏病的女性来说,怀孕是她们向往却又很担心的一件事。作为一名产科医生,我们常常会被问:“医生,我有心脏病,能怀孕吗?”

目前,年轻人中常见的心脏病有先天性心脏病(房间隔缺损、室间隔缺损等),风湿性心脏病(二尖瓣狭窄等),心律失常(房早、室早等)和心肌病(肥厚型心肌病等)。心脏病女性的怀孕过程会异常艰辛,因为妊娠后孕产妇的血容量和心排出量逐渐增加,到怀孕第32周~34周的时候比平时要增加1/3左右;分娩的时候,由于产妇用力,肺脏和腹部的压力都会急剧增高,回心血量增加。这些改变对心脏病妇女而言无疑是沉重负担。

心脏病妇女能否怀孕主要取决于心脏疾病的严重程度和孕前心功能的情况。一般而言,心脏病变较轻(包括小型房缺、室缺,手术纠正的简单先心病,药物控制好的心律失常等);心功能I-II级(能胜任日常体力活动或轻便劳动者),既往无心力衰竭和其他并发症者可以妊娠。

心脏病变严重(包括先天性心脏病伴有紫绀、重度肺动脉高压、风湿性心脏病重度主动脉狭窄及重度二尖瓣狭窄、风湿热活动期、心脏病并发细菌性心内膜炎、复杂的主动脉缩窄、主动脉根部直径扩大的马凡综合征、突发致命的心律失常、伴有心室功能不全的围产期心肌病、急性心肌梗死),心功能III-IV级(轻微劳动便出现心悸、气急),既往有心力衰竭,年龄35岁以上心脏病程较长者不宜妊娠。

另外,先天性心脏病具有遗传倾向。如果父母一方患有先天性心脏病,那么,婴儿先天性心脏病的发病率是一般人群发病率的6倍。所以先心病妇女应在妊娠前咨询以确定后代的遗传风险。

患有心脏病的女性切忌盲目怀孕,计划怀孕前一定要先去心脏专家和产科专家处就医,做全面检查,评估心脏疾病的严重程度,评估心功能情况,只有在心脏专家和产科专家的许可和严密观察下才能妊娠,并通过药物及手术治疗使心脏功能达到最佳状态以减少妊娠风险的发生。

不宜妊娠者,应做好避孕措施,一旦怀孕,应该在怀孕头3个月内做人工流产。可以妊娠的心脏病妇女,孕期应与医生密切配合,定期做好孕期检查,适当增加产检频率,以便医生根据病情变化而给予必要的治疗,使自己安全度过孕期并拥有健康的宝宝。

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    2017-10-17 Y—xianghai

    学习了新知识

    0

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    2017-10-17 榄枷檬

    心脏病妇女能否怀孕主要取决于心脏疾病的严重程度和孕前心功能的情况.

    0

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    2017-10-17 wqkm

    好文章

    0

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    2017-10-17 183****7028

    学习

    0

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    2017-10-17 明月清辉

    谢谢分享.学习了

    0

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患儿男性,6个月,身高58cm,体重5.6kg。出生后3个月因“感冒”就诊发现心脏杂音。超声心动图诊断为先天性心脏病,室间隔缺损,主动脉缩窄。入院后行先天性心脏病复杂畸形手术。本病例将对先天性心脏病术后如何护理、患儿是否存在膈肌麻痹的诊断以及护理中的注意事项进行详细阐述。

2017 AHA科学声明:成人先天性心脏病患者非心脏并发症的诊断和管理

2017年10月,美国心脏协会(AHA)发布了成人先天性心脏病患者非心脏并发症的诊断和管理声明,文章主要介绍了先天性心脏病患者并发肾脏,肺,肝脏,免疫以及感染性疾病,血液疾病,内分泌疾病,肿瘤,血管疾病和非心脏手术的诊断和管理等内容。

Nature Genetics:新发现!先天性心脏病相关基因

NHLBI小儿心脏基因组联盟(PGCG)最新一篇《Nature Genetics》文章报道了一些CHD的遗传致病因素,还揭示了携带这些遗传突变的CHD病例的长期前景。

Circulation:接受心导管插入术的先心病患者主要不良结局模型的建立

该研究旨在建立先天性心导管插入术后不良结局的经验证风险标准化模型。

EUR RADIOL:利用自导航自由呼吸全心磁共振血管成像在先天性心脏病冠状动脉评估的价值

心的形状如一倒置的、前后略扁的圆锥体,如将其视为头部,则位于头顶部、几乎环绕心脏一周的冠状动脉恰似一顶王冠,这就是其名称由来。冠状动脉是供给心脏血液的动脉,起于主动脉根部,分左右两支,行于心脏表面。采用Schlesinger等的分类原则,将冠状动脉的分布分为三型: 1、右优势型;2、均衡型;3、左优势型。本研究旨在评价自导航自由呼吸3D(SNFB3D)全心MRA技术在评估先天性心脏病(CHD)冠状